Terminal cancer, sometimes called end stage cancer, is any type of cancer that doctors cannot treat or cure. Terminal cancer does not respond to treatment, and doctors cannot slow its progression.

A terminal cancer diagnosis can be overwhelming. It can present several emotional and practical challenges.

People may find different ways to cope, come to terms with the diagnosis, and make decisions about the next steps.

This article looks at what terminal means, the life expectancy of someone with terminal cancer, and treatment options.

It also looks at the next steps after diagnosis, questions to ask a healthcare team, and where to find support.

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When cancer is terminal, doctors cannot cure it. Treatment cannot significantly prolong a person’s life.

Doctors may not expect a person with terminal cancer to live beyond a certain amount of time. The aim of treatment may move from treating the cancer to reducing the severity of symptoms.

Any cancer can become terminal, although some may be more likely than others to reach an untreatable stage.

Terminal vs. advanced cancer

Although some people use the terms “advanced” and “terminal” interchangeably, they have different meanings.

Doctors cannot cure advanced cancer but can prolong a person’s life and slow the progression of the cancer through treatment.

What stage of cancer is terminal?

Stage 4 is the most advanced stage of cancer.

However, not all cases of stage 4 cancer are terminal. Survival rates can depend on various factors, including the type of cancer. At this stage, cancer has spread from the primary location to distant areas of the body.

People may also refer to cancer as being in the early, advanced, and terminal stages.

The length of time a person may survive with terminal cancer can vary. Doctors take a variety of factors into account before they estimate a person’s life expectancy.

Doctors may use guidelines such as the Karnofsky performance scale and the palliative performance scale (PPS) to help determine life expectancy.

These guidelines help doctors measure aspects of a person’s functional performance and provide a score that helps them narrow their estimation of a person’s life expectancy.

The PPS is a more modern adaptation of the Karnofsky scale. It looks at factors including a person’s activity level, self-care, and level of consciousness.

In some cases, doctors may hesitate to provide an estimated life expectancy.

Is it possible to survive terminal cancer?

Typically, terminal cancer does not respond to any treatment.

Although it is unlikely, there are cases of people having survived a terminal diagnosis for significantly longer than doctors had estimated.

In most cases, however, a terminal cancer diagnosis means a person will not survive.

After confirming a terminal cancer diagnosis, doctors typically focus treatment away from trying to treat the disease.

Instead, treatment focuses on relieving symptoms, such as pain and nausea. Doctors aim to help a person feel more comfortable and at ease during the final months of life.

However, a person may choose to continue treatment.

Palliative care

A person can receive palliative care throughout their experience with cancer, not only when doctors have stopped other treatments.

Palliative care involves treating and preventing cancer symptoms, helping address the concerns of those with cancer and their loved ones, and providing emotional support.

Methods of treatment in palliative care are sometimes similar to cancer treatment. For example, doctors may use radiation therapy, chemotherapy, or surgery to reduce pain.

Clinical trials

Researchers may offer a person with terminal cancer the option of participating in a clinical trial. These trials help assess the safety and efficacy of new treatments.

It is unlikely that a clinical trial will significantly improve a person’s health status, and they may involve risks. But clinical trials can offer potential benefits and help determine future treatments.

Hospice care may take place at home or in a special facility. It typically involves relief of symptoms, grief counseling and support, and helping a person live as comfortably as possible during their remaining months.

Unlike palliative care, people do not receive hospice care for the entirety of their cancer experience alongside other treatments.

Hospice care is completely focused on helping a person feel comfortable and supported. The treatment is not focused on delaying or hastening the end of a person’s life.

There is no correct response when a person receives a terminal diagnosis. A person may feel overwhelmed or numb, and their feelings may fluctuate. A person may experience several emotions, such as sadness, fear, anger, grief, and regret.

A person may also feel overwhelmed by practical considerations, such as deciding on hospice care and organizing their will and other documents.

Emotional considerations

There are a range of emotions someone may feel after diagnosis. It is normal for people to experience these emotions. They should allow themselves to feel them and reach out to their care team and others for help.

For example, if someone experiences symptoms of depression, they can contact a doctor to discuss ways to manage and treat these symptoms. Counseling, medication, and other resources may help a person cope.

A person may also experience grief, which may feel similar to depression. Grief may cause a person to feel tired, confused, angry, and fearful. Some people may grieve for the loss of unfulfilled plans, the loss of things they used to be able to do, or for the way their bodies used to function.

There is no single or correct way to grieve or move through grief. A person should take the time to sit quietly and focus inward if they need to. Some people may feel better if they reach out to friends and loved ones.

Practical considerations

Practical considerations for the end of life may include the following:

  • Planning for the estate: A person can contact a lawyer to prepare documents that outline how to handle their estate. These documents include a will, a power of attorney, and a living trust.
  • Implementing advance healthcare directives: A person may prepare legal documents that outline how they wish their medical care to continue.
  • Organizing important paperwork: It may be helpful to gather important documents into one place and let a trusted person or lawyer know where they are.
  • Research hospice options: A person can look for a reputable, licensed hospice service that best fits their needs.
  • Funeral arrangements: To ensure they are laid to rest according to their wishes, a person can make arrangements for their funeral with the help of family and friends.

Questions a person may want to ask their healthcare team include:

  • How long am I likely to live?
  • What are my treatment choices?
  • What are the risks and benefits of my treatment options?
  • How will a healthcare team manage the symptoms of cancer?
  • How will the cancer affect me as it progresses?
  • What is the goal of the treatment?
  • Am I eligible for a clinical trial?

A person may also find it helpful to ask their doctor for various resources, such as recommendations for palliative care specialists, hospice care services, and mental health professionals.

People with terminal cancer and their loved ones may find it helpful to join an in-person or online support group. A support group can help them share their experiences and receive support from like-minded peers.

Counseling sessions with a mental health professional may also help a person cope with emotional challenges.

To find a support group, a person can:

The American Cancer Society also provides several resources, which include:

  • support groups
  • information centers
  • online networks
  • residential and transport options for treatment

Below are answers to some frequently asked questions about terminal cancer.

What are the symptoms of terminal cancer?

The symptoms of terminal cancer can include:

  • appetite loss
  • loss of bowel and bladder control
  • pain
  • difficulty breathing
  • dry lips
  • cold skin
  • confusion

What types of cancer are terminal?

Any cancer that advances to a stage that does not respond to treatment can become terminal.

Terminal cancer does not respond to treatment, and doctors cannot slow its progression. Often, the goal of treatment for someone with terminal cancer is to reduce the severity of cancer symptoms.

A person may choose to continue treatment or may decide on palliative or hospice care.

Receiving a diagnosis of terminal cancer can be emotionally and practically overwhelming. People may cope with the diagnosis in different ways, such as through psychotherapy or counseling and spending time with loved ones.

It may be helpful for a person to arrange their financial and future healthcare plans while they are well enough to make decisions.